Systems Integration Specialist

Zelis Healthcare Clearwater, FL

Zelis is a healthcare information technology company and market-leading provider of end-to-end healthcare claims cost management and payment solutions.

Inc.5000 award winner: One of the fastest growing privately held companies in the US!

Ranked #1 by NJ Biz as the Fastest Growing Company in NJ!


COMPANY BACKGROUND/CULTURE

Zelis Healthcare is a market-leading healthcare technology company providing integrated healthcare cost management and payments solutions including network analytics and design, network access and cost management, claims cost management and electronic payments to payers, healthcare providers and consumers in the medical, dental and workers’ compensation markets nationwide. Zelis Healthcare is backed by Parthenon Capital Partners. www.Zelis.com

Position Overview

Zelis is pursuing an aggressive organic and non-organic growth strategy focused on providing superior healthcare claim lifecycle solutions to payors, providers and individuals from pre-payment through payment. As the company executes its growth strategy, Zelis is seeking to identify an accomplished Systems Integration Specialist. Reporting directly to the Director of Integrations, and working closely with managers and other team members.

KEY RESPONSIBILITIES

  • Responsible for the integration/implementation of new client accounts by utilizing an EDI interface which may be a currently supported file format (flat file, 835, etc) or a new file format
  • Utilize SQL to analyze data to ensure a defect free integration/implementation process.
  • Utilize SQL to update system configuration data across multiple client environments
  • Troubleshoot client issues including but not limited to: file structure, data integrity, load failures, and file transmission failures while utilizing tools such as Linq or T-SQL, to research and correct. The issues could occur in the clients UAT or Production environments
  • Participate in client calls and provide solutioning to technical issues that may arise. Must be able to communicate solutions in a manner suitable for client consumption
  • Responsible for the implementation of any new vendor relationship using Electronic Data Interchange. Supports and Educates operations team regarding technologies used and workflow.
  • Data mining analysis to identify root cause behind trends and drivers which could impact daily production, Payments market penetration and revenue streams.
  • Document change specifications for development teams then execute user acceptance testing
  • Perform steps necessary to transition clients from TEST environment to PRODUCTION environment
  • Maintain awareness of and ensure adherence to Payments standards regarding HIPAA and other privacy concerns.
  • Provide recommendations to improve processes, data platforms, reporting and analytic methods
  • Reviewing and troubleshoot inquiries from providers, clearinghouses and payers as it relates to concerns of not receiving or non-compliant 835’s.
  • Proactively troubleshoot 835’s not sent due to non-compliance. Troubleshooting steps include executing reporting/queries or manually reviewing 835 files to identify non-compliant data elements.
  • Setting up direct data connections with new clearinghouse partners.

professional experience/qualifications (TOP 3-5 SKILLS DESIRED)

  • Experience working in a SQL DBMS environment required
  • Familiar with common types of connectivity solutions (FTP/Secure FTP), VPN)
  • Experience with different file formats (fixed length, delimited, XML, X12) required
  • Experience reviewing, analyzing and troubleshooting EDI 835 (5010) Files
  • Project management experience preferred
  • Experience with SSIS for data extraction a plus
  • Health insurance claim adjudication knowledge a plus

EDUCATION:

  • Bachelor’s degree preferred

COMPENSATION:

An attractive compensation package as well as comprehensive benefits plans are available to attract outstanding candidates.


Thank you for your interest in the Zelis team!


See Job Description